IVY 2 DENTAL PLLC NPI 1306372503

NPI Information

  • NPI: 1306372503
  • Provider Name: IVY 2 DENTAL PLLC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Former Legal Business Name: WOPD, PLLC
  • Address: 5144 W OLIVE AVE
    GLENDALE, AZ
    ZIP 85302
  • Phone: (623) 939-9944

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NPI Details

IVY 2 DENTAL PLLC is a pediatric dentistry dentist in Glendale, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. IVY 2 DENTAL PLLC NPI is 1306372503. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Wopd, Pllc.

The provider's business location address is:

5144 W OLIVE AVE
GLENDALE, AZ
ZIP 85302-209
Phone: (623) 939-9944

The provider's authorized official is Umar M Imtiaz .
The authorized official title is Associate Provider and has the following contact phone number (623) 444-9999.

The enumeration date for this NPI number is 5/8/2017 and was last updated on 7/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry7256ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1274792MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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